The complexities and nuances for successfully treating chronic sinusitis usually involves two medical specialists, an otolaryngologist-head and neck surgeon (also called an ENT) and an allergist/immunologist.

Patients with this condition usually see these two specialists in separate appointments.

Now USF Health is offering a merged clinic for patients with chronic sinusitis and related conditions where they will have one appointment with both an ENT and an allergist at the same time.

Farnaz Tabatabaian, MD, associate professor in the Department of Allergy and Immunology in the USF Health Morsani College of Medicine, and Mark Tabor, MD, associate professor in the Department of Otolaryngology Head and Neck Surgery in the USF Health Morsani College of Medicine, have combined their expertise and their clinics to form this new merged clinic.

The aim is to more effectively treat patients by being more efficient with the treatment plan, Dr. Tabatabaian said.

“We’re an academic institution so we see more complex conditions,” Dr. Tabatabaian said. “Bringing these two specialties into one clinic, one visit for the patient, makes incredible sense, not just for convenience but also for continuity of care and better outcomes. An ENT and an immunologist both in the room will better help meet the needs of patients experiencing the most complex sinusitis cases.”

Those with chronic sinusitis need the expertise of both an ENT and an allergist because they may need surgery to address the physical and structural problems, which the ENT will provide, and then also need allergy shots, antibiotics and, perhaps, biologics from the allergist to address the underlying immune and inflammatory response. Most patients will need both approaches but, as typically happens, the time between appointments allows the condition to return, causing patients to need further care and starting the cycle of treatments and procedures over again.

“Done separately, the condition isn’t fully treated, meaning patients may go back and forth with ENT and allergist appointments,” Dr. Tabor said. “The structural fix only lasts until the immune system flares up again and sinusitis returns, or the immune system is calmed and the barriers in the structure continue to limit and sinusitis returns. By addressing both structural and immune response at once, treating the two root causes together, patients will fare better for beating the return of sinusitis.”

“The therapies are available, but the collaborative environment in one clinical setting means we are offering precision medicine at its core,” Dr. Tabatabaian said. “Combining our clinics into one collaborative setting means we are taking great care of patients and also learning from each other as colleagues.”

The USF Health combined clinic is also a great educational opportunity for medical students, resident physicians and fellows. And for patients, the merged clinic also means greater access to clinical trials for new therapies.

Chronic rhinosinusitis is inflammation of the nasal and sinus linings, nasal blockage, rhinorrhea, facial pressure/pain and loss of sense of smell, and may include nasal polyps.

Patients seeking appointments at this new USF Health combined clinic will need to have a diagnosis of chronic sinusitis and have tried but not benefited from traditional therapies. Ask your physician about a referral to the clinic to see if your condition qualifies.

In February 2007, Colleen Johnson was diagnosed with an autoimmune disease called Wegener Granulomatosis (GPA). This is an uncommon disorder that is the result of granulomatous inflammation and blood vessels Inflammation, which can damage organ systems.

The condition affected her health by causing the cartilage in her nose to dissolve and, as a result, made it collapse. This obstructed her airways and made it impossible for her to breathe through them, which also caused her to develop a saddle-nose deformity.

“With this disease it is painful and it’s more painful when it hits the organs, but with my part, I had the nose that collapsed. I could not breathe through my nose, so I was not getting enough oxygen to go into my brain. I couldn’t do all the functions I wanted to do; it just affected my everyday life” Johnson said.

After years of struggling with her condition, Colleen was finally referred to Dr. Mark Tabor, MD, assistant professor in the Department of Otolaryngology. During their consultation, Dr. Tabor discovered a huge pocket of dead bone within her frontal sinus. He then immediately scheduled her for an operation called a Frontal Sinus Drillout. This helped remove the causes of her sinus blockage and helped stop some of the pain she was experiencing.

Dr. Tabor also informed Colleen that he could address her saddle-nose deformity, which was also caused by her condition. He contacted Dr. Julia Toman, MD, assistant professor in the Department of Otolaryngology, due to her specialization in addressing the structural parts of the nose, such as the bone and cartilage that give the nose shape.

From left, Dr. Julia Toman, Colleen Johnson, and Dr. Mark Tabor.

“Being at an academic medical center, we have experts within many different specialties, so I think it is good to get different people involved in specialized cases like this. Two sets of eyes are better than one,” Dr. Tabor said.

With the combined efforts of Dr. Tabor and Dr. Toman, they were able to restore function back to her nose by using cartilage from other parts of her body to reconstruct her nasal breathing airways and open up her sinuses.

“When I got the procedure done, I did not think it would ever happen because my nose had been collapsed for at least 10 years, so I thought it was going to be my life forever,” Johnson said. “I just want to thank Dr. Tabor and Dr. Toman, for what they did for me because if not for them, then my life would still be the worst thing in the world. They improved my life 100 percent, and I cannot thank them enough.”

Story, photos and video by Ryan Rossy, USF Health Communications and Marketing